Q: I take immune-suppressing drugs for multiple sclerosis. During flu season, I wear a face mask to protect myself from viruses.
I also wear one whenever I travel. I felt a little awkward the first time I wore a mask on an airplane, but I soon realized that it was my “superpower.” People seem to avoid me, which is just fine. I also bring hand sanitizer to wipe down the tray table, armrests and anything else that I will end up touching.
Answer: We applaud your prudence. Millions of people are now taking immune-suppressing drugs for rheumatoid arthritis, psoriasis, colitis and other serious auto-immune conditions. This may leave them more vulnerable to infection.
A level three surgical mask is as effective as a disposable respirator (N95) against viral transmission (JAMA, Sept. 3, 2019). Hand-washing is also considered protective.
Q: You recently wrote about the problem of mail-order medicines being left in the cold for hours. This is a real problem.
I used to work as a pharmacy technician for a mail-order pharmacy owned by a major insurance company. Temperature was our enemy, but we did our best. We shipped medications that had to be kept cool, like insulin, in little Styrofoam coolers with ice packs. We never shipped perishable medications on Friday so that they wouldn’t sit in hot warehouses over the weekend.
We were acutely aware of destinations and asked patients who wouldn’t be home at delivery if we could ship to workplaces or neighbors who would take the package indoors immediately. Even so, we had daily calls from people who received hot or freezing medications.
Our pharmacists’ best guess was “It should still be OK,” since we had no control over the shippers’ procedures. We always replaced questionable meds, but we often had the same problem with the replacements.
Answer: Thank you for explaining the mail-order problem so clearly. We normally hear from patients who also have no control over shipping. For example, one reader wrote:
“I ordered CoQ10 capsules. When the bottle arrived, the capsules had swollen. I used a thermometer and found the caps were over 110 degrees. I got a refund, but I’ll never order medicines or supplements for home delivery again.
“There’s no way of knowing where our medicines originate and how they’re transported. This could affect their quality. I guess someone has to pay with their health to get action taken by the FDA.”
Sadly, the Food and Drug Administration has no jurisdiction over shipping. That is regulated state by state, and there is virtually no oversight.
Q: I had my thyroid removed as a result of Graves’ disease many years ago. I take Synthroid, and my doctor tells me my TSH levels are normal. Nevertheless, I suffer from chronic, low-grade fatigue, depression and lethargy. I think I heard on your radio show that there is a different treatment. Could you tell me more?
Answer: Dr. Antonio Bianco is an endocrinologist who has studied this challenge. He reports that some people do not efficiently convert T4 (levothyroxine, aka Synthroid) to the active form of thyroid hormone, T3 (triiodothyronine). They may feel better if they also take some T3. You can learn more about this and other strategies in our eGuide to Thyroid Hormones. This online resource may be found in the Health eGuide section of www.PeoplesPharmacy.com.
King Features Syndicate